基于高精度X光与CT配准的电磁导航系统用于股骨截骨术 / Electromagnetic Navigation for Femoral Osteotomy Using High-Accuracy X-ray-to-CT Registration
1️⃣ 一句话总结
本文提出一种新型电磁导航系统,通过仅用两张X光片与CT进行高精度配准,实现术中无需额外辐射的实时导航,显著提升了股骨截骨手术的准确性,其效果优于徒手操作,并与传统个性化导板(PSI)的精度相当,同时减少了对手术暴露和辐射的需求。
Accurate execution of preoperative plans in corrective femoral osteotomies remains challenging. Current techniques are limited by variable accuracy, invasiveness, and radiation exposure, with free-hand methods and patient-specific instrumentation (PSI) often requiring >30 and >6 fluoroscopic images, respectively. We present an integrated, electromagnetic tracking (EMT)-based navigation system for femoral osteotomies that minimizes dissection and intraoperative fluoroscopy. The system couples CT-based preoperative planning with one-time intraoperative C-arm calibration and accurate X-ray-to-CT registration from two fluoroscopic images acquired at initialization. This enables real-time, fluoroscopy-free EMT navigation of the saw blade and bone fragments relative to the preoperative plan, and is compatible with uniplanar and biplanar osteotomies. In a feasibility study using 18 synthetic femora, EMT guidance significantly outperformed free-hand execution in total angular error ($(3.05 \pm 0.75)^\circ$ vs.\ $(6.32 \pm 2.36)^\circ$, $p=0.031$), assuming the same minimal surgical exposure for both. No EMT-guided trials exceeded the >5° clinical threshold, whereas free-hand produced 4 outliers of 6 trials. The system achieved statistical equivalence ($\pm 2^\circ$, $\pm 2,\text{mm}$) to PSI for total angular ($p \le 0.02$) and total translational ($p=0.048$) errors, with no significant differences in user questionnaire scores. By transferring preoperative plans using only two fluoroscopic images while matching PSI accuracy without additional surgical exposure, the proposed system motivates subsequent cadaveric and clinical validation.
基于高精度X光与CT配准的电磁导航系统用于股骨截骨术 / Electromagnetic Navigation for Femoral Osteotomy Using High-Accuracy X-ray-to-CT Registration
本文提出一种新型电磁导航系统,通过仅用两张X光片与CT进行高精度配准,实现术中无需额外辐射的实时导航,显著提升了股骨截骨手术的准确性,其效果优于徒手操作,并与传统个性化导板(PSI)的精度相当,同时减少了对手术暴露和辐射的需求。
源自 arXiv: 2606.03893